Minimally Invasive Direct Coronary Artery Bypass: Current Experience


  • Hitoshi Hirose
  • Atsushi Amano
  • Akihito Takahashi



Background: Minimally invasive direct coronary artery bypass (MIDCAB) via a small incision has been performed for revascularization of the left anterior descending artery with the left internal mammary artery. In this study, we analyzed outcome in patients who underwent MIDCAB.

Methods: Between June 1997 and July 2002, a total of 125 patients (96 men and 29 women; mean age, 65.1 ± 9.6 years) underwent MIDCAB. Perioperative and follow-up data were entered into a structured database.

Results: Coronary anastomosis time was 17.0 ± 5.0 minutes. Mean intubation period, intensive care unit stay, and postoperative hospital stay were 4.0 ± 2.8 hours, 1.3 ± 0.8 days, and 9.7 ± 4.6 days, respectively. There were no hospital deaths or cases of postoperative heart failure, myocardial infarction, renal failure, prolonged ventilation ( > 2 days), or stroke. During the follow-up period of 3.3 ± 1.5 years, 12 patients developed angina, and there were 10 deaths. The actuarial 3-year survival rate was 92.6%, and the event-free rate was 87.1%.

Conclusion: MIDCAB can be performed with early recovery with minimum mortality and morbidity. The long-term results after MIDCAB are acceptable.


Riess FC, Bader R, Kremer P, et al. 2002. Coronary hybrid revascularization from January 1997 to January 2001: a clinical follow-up. Ann Thorac Surg 73:1849-55.nSubramanian VA. 1997. Less invasive arterial CABG on a beating heart. Ann Thorac Surg 63:S68-71.nCremer J, Mugge A, Wittwer T, et al. 1999. Early angiographic results after revascularization by minimally invasive direct coronary artery bypass (MIDCAB). Eur J Cardiothorac Surg 15:383-8.nDiegeler A, Thiele H, Falk V, et al. 2002. Comparison of stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery. N Engl J Med 347:561-6.nDoty JR, Fonger JD, Salazar JD, Walinsky PL, Salomon NW. 1999. Early experience with minimally invasive direct coronary artery bypass grafting with the internal mammary artery. J Thorac Cardiovasc Surg 117:873-80.nIzzart MB, Yim APC, El-Zufari MH. 1998. Minimally invasive left anterior descending coronary artery revascularization in high-risk patients with three-vessel disease. Ann Thorac Cardiovasc Surg 4:205-8.n



How to Cite

Hirose, H., Amano, A., & Takahashi, A. (2005). Minimally Invasive Direct Coronary Artery Bypass: Current Experience. The Heart Surgery Forum, 6(6), E129-E132.